title: A non-invasive fibrosis score predicts treatment outcome in chronic hepatitis C virus infection.
abstract: OBJECTIVE
  The results of a previous study suggest that an index calculated according to the formula (normalized ASAT x PK-INR) x 100/thrombocyte count (x 10(9)/L; GUCI) may reflect liver fibrosis in patients with chronic hepatitis C virus (HCV) infection. The aims of the present study were (i) to validate the association between the Göteborg University Cirrhosis Index (GUCI) score and liver fibrosis and (ii) to evaluate the utility of this index in predicting the outcome of antiviral treatment.
  
  
  METHODS
  A total of 269 patients with chronic HCV infection, stratified according to HCV genotype (1/4 versus 2/3) participated in a phase III trial using pegylated interferon alpha-2a and ribavirin (DITTO study). Retrospective analyses of the baseline GUCI scores and assessments of pretreatment liver biopsies using the Ishak protocol were performed. Cut-off GUCI scores were calculated to distinguish patients with a high or low probability of sustained viral response (SVR).
  
  
  RESULTS
  Striking associations between GUCI and Ishak fibrosis stages (stages 0-2 versus stages 3-4, p = 0.0002, stages 3-4 versus stages 5-6, p = 0.002) were observed. In patients with genotype 1 or 4, a GUCI score below 0.33 was associated with a rapid viral response to antiviral treatment and an SVR rate of 80%. Ninety-two percent of patients (92/101) with a SVR had a pretreatment GUCI score below 1.11.
  
  
  CONCLUSIONS
  Our results suggest that the GUCI score appropriately reflects the stage of liver fibrosis in HCV-infected patients, and predicts initial viral kinetics as well as treatment outcome in patients infected with HCV genotype 1 or 4.
authors.affiliation: Department of Infectious Diseases, Göteborg University, Sweden. johan.westin@infect.gu.se
authors.forename: Johan
authors.initials: J
authors.lastname: Westin
authors.forename: Magdalena
authors.initials: M
authors.lastname: Ydreborg
authors.forename: Sara
authors.initials: S
authors.lastname: Islam
authors.forename: Asa
authors.initials: A
authors.lastname: Alsiö
authors.forename: Amar P
authors.initials: AP
authors.lastname: Dhillon
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Pawlotsky
authors.forename: Stefan
authors.initials: S
authors.lastname: Zeuzem
authors.forename: Solko W
authors.initials: SW
authors.lastname: Schalm
authors.forename: Carlo
authors.initials: C
authors.lastname: Ferrari
authors.forename: Avidan U
authors.initials: AU
authors.lastname: Neumann
authors.forename: Kristoffer
authors.initials: K
authors.lastname: Hellstrand
authors.forename: Martin
authors.initials: M
authors.lastname: Lagging
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use; D005260:Female; D019698:Hepatitis C, Chronic / Q000188:drug therapy* / Q000473:pathology*; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000627:therapeutic use; D008103:Liver Cirrhosis / Q000473:pathology*; D008297:Male; D011994:Recombinant Proteins; D012189:Retrospective Studies; D012254:Ribavirin / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D012254:Ribavirin